The Effect of Phosphate Binders in Patients With End Stage Kidney Disease Undergoing Hemodialysis: a Prospective Observational Study

To compare the clinical efficacy of sevalamer carbonate and lanthanum carbonate in chronic hemodialysis patients. This prospective observational study included 80 patients randomly divided into two groups were followed from December 2019 to December 2020. After 12 months of maintenance hemodialysis treatment with sevalamer carbonate or lanthanum carbonate, serum phosphorus, serum calcium, alkaline phosphatase(ALP), parathyroid hormone (iPTH), low-density lipoprotein(LDL), hemoglobin(HGB), triglycerides(TG) and albumin(ALB) were evaluated. The adequacy of dialysis, the effective rate of treatment and the incidence of adverse reactions were compared as well. After treatment, In lanthanum carbonate group, serum phosphorus and iPTH decreased and albumin increased, the difference was significant(P < 0.05). In sevalamer carbonate group, serum phosphorus and LDL decreased and albumin increased after treatment, the difference was significant(P < 0.05). There was no significant difference in the dialysis adequacy and total effective rate between the two groups (P>0.05). However, the incidence of gastrointestinal adverse reactions in the sevalamer carbonate group was lower than in the lanthanum carbonate group and the difference was significant (P < 0.05). The two phosphate binders are safe and effective for the treatment of hyperphosphatemia in patients with ESKD undergoing maintenance hemodialysis. Nevertheless, sevalamer carbonate seems to be superior with lowering the incidence of gastrointestinal adverse reactions and improving lipid metabolism.

The Effect of Phosphate Binders in Patients With End Stage Kidney Disease Undergoing Hemodialysis: a Prospective Cohort Study

Background: To compare the clinical efficacy of sevalamer carbonate and lanthanum carbonate in chronic hemodialysis patients. Methods: This prospective observational study included 76 patients with follow-up from September 2019 to December 2020. After 15 months of maintenance hemodialysis treatment with sevalamer carbonate or lanthanum carbonate, serum phosphorus, serum calcium, alkaline phosphatase(ALP), parathyroid hormone (iPTH), low-density lipoprotein(LDL), hemoglobin(HGB), triglycerides(TG) and albumin(ALB) were evaluated. The adequacy of dialysis, the effective rate of treatment and the incidence of adverse reactions were compared as well. Results: After treatment, In lanthanum carbonate group, serum phosphorus and iPTH decreased and albumin increased, the difference was significant(P < 0.05). In sevalamer carbonate group, serum phosphorus and LDL decreased and albumin increased after treatment, the difference was significant(P < 0.05). There was no significant difference in the dialysis adequacy and total effective rate between the two groups (P>0.05). However, the incidence of adverse reactions in the sevalamer carbonate group was lower than in the lanthanum carbonate group and the difference was significant (P < 0.05). Conclusion: The two phosphate binders are safe and effective for the treatment of hyperphosphatemia in patients with ESKD undergoing maintenance hemodialysis. Nevertheless, sevalamer carbonate seems to be superior with lowering the incidence of gastrointestinal adverse reactions and improving lipid metabolism.

The study of Dominican amber-bearing sediments from Siete Cañadas and La Cumbre with a discussion on their origin

The paper presents comprehensive mineralogical and geochemical characteristics of Dominican amber-bearing sediments from Siete Cañadas, Hato Mayor Province of the Eastern Mining District (EMD) in the Cordillera Oriental. The characteristics of rocks collected from the borehole in Siete Cañadas area (EMD) were compared with petrography of coaly shales from La Cumbre in the Northern Mining District (NMD). The mineralogy of the rocks was determined using transmitted and reflected light microscopy, scanning electron microscopy, Powder X-ray diffraction and Fourier Transform Raman Spectroscopy. Biomarker analyses by the gas chromatography–mass spectrometry were used to trace the genetic source and transformation stage of organic matter hosted in the core sediments. In this study, the characteristics of rocks from La Cumbre were supplemented with the petrographic data from our studies reported earlier. Based on the findings, it has been concluded that the basins in the investigated parts of the EMD and NMD regions were likely characterized by different, isolated palaeosettings. Transformation and maturation of terrigenous material were affected by locally occurring physicochemical conditions. In both amber deposits, the sedimentation of clastic and organic material proceeded in the presence of marine conditions. In case of the La Cumbre deposit (NMD area), the sedimentation underwent probably in the conditions of the lagoon environment, a shallow maritime lake or periodically flooded plain that facilitated organic matter decomposition and carbonation from meta-lignite to sub-bituminous coal (random reflectance of coal—Rro = 0.39%). In the Siete Cañadas (EMD region), the sedimentation took place in a shallow saltwater basin, where terrigenous material was likely mixed with material found in situ (fauna fossils, carbonate-group minerals) to form the mudstones enriched in bituminous substance of low maturity. The organic matter found in the rocks from both deposits is of mixed terrestrial/marine origin and was deposited in the presence of low oxygen concentration and reducing and/or dysoxic conditions.

Investigating the preventive effects of 99Tc-methylenediphosphonate on glucocorticoid-induced osteoporosis rabbit model

Background and Objective: Osteoporosis is a worldwide healthcare challenge. Conventional medications for osteoporosis prevention are not clinically effective or associated with gastrointestinal tract adverse effects. The present study aimed to comparatively investigate the effects of technetium-99 conjugated with methylene diphosphonate (99Tc-MDP) and calcium carbonate and alendronate in prevention and treatment of osteoporosis in glucocorticoid-induced osteoporosis rabbit model through evaluating bone alkaline phosphatase (B-ALP), TRAP-5b levels and histopathological parameters. Method: Forty healthy female New Zealand rabbits were randomly divided into five groups (each n=8), including control group (Control Group), osteoporosis model group (GIO Group), osteoporosis model + 99Tc-MDP group (99Tc-MDP Group), osteoporosis model + alendronate group (Alendronate Group), and osteoporosis model + calcium carbonate group (calcium carbonate Group). Animals in each group were treated with corresponding interventions for 14 weeks. The blood samples were collected at the first and 14th week, and B-ALP and TRAP-5b levels were detected by enzyme-linked immunosorbent assay (ELISA). The rabbits were anesthetized at the 14th week, and pathological cytological observation was performed on both femurs. Results: Age and weights of rabbits in different groups had no statistically significant differences (P>0.05). B-ALP levels in serum of all groups except for Control Group decreased after treatment, but the differences were not statistically significant (P>0.05). TRAP-5b levels in serum of all groups increased after treatment. Specifically, differences in the GIO Group and Calcium carbonate Group were statistically significant (P<0.05), while differences in 99Tc-MDP Group and Alendronate‎ Group were not statistically significant (P<0.05). Pathological sections revealed that Control Group presented normal bone tissue morphology. The bone tissue morphology of the 99Tc-MDP Group and Alendronate Group was similar to Control Group and GIO Group. Moreover, Calcium carbonate Group and GIO Group exhibited similar bone tissue morphology. Conclusions: 99Tc-MDP has preventive effect on the glucocorticoid-induced osteoporotic rabbit model. This osteoporosis preventive effect might be attributed to the capacities of 99Tc-MDP in promoting the osteoblasts generation and inhibiting the generation and reducing the activity of osteoclasts.

The Characteristics and Origin of Amber Deposits in the Dominican Republic

Mineralogical and geochemical characteristics of amber deposits located in the Dominican Republic, i.e., Hato Mayor Province of the Eastern Mining District (EMD) in the Cordillera Oriental, and Santiago Province of the Northern Mining District (NMD) in the Cordillera Septentrional were performed. The results of analyses of amber-bearing sediments collected from the borehole in Siete Cañadas area (EMD) were referenced to the petrological data obtained for the coaly shales from La Cumbre (NMD). The mineralogy of the rocks was described using transmitted and reflected light microscopy, scanning electron microscopy, Powder X-ray diffraction and Fourier Transform Raman Spectroscopy. Biomarker analyses by the gas chromatography-mass spectrometry were used to trace the genetic source and transformation stage of abundant organic matter hosted in the core sediments. Our findings indicated that basins in EMD and NMD regions were different isolated palaeosettings, in which under the influence of local physicochemical factors the terrigenous material was transformed and got maturated. In both amber deposits, the sedimentation of clastic and organic material proceeded in the presence of marine conditions. In case of the NMD area, the sedimentation underwent probably in the conditions of the lagoon environment, a shallow maritime lake or periodically flooded plain, that facilitated organic matter decomposition and carbonation from meta-lignite to sub-bituminous coal (random reflectance of coal - Rro = 0,39%). In the EMD region, the sedimentation took place in a deeper basin, where terrigenous material was likely mixed with material found in situ (fauna fossils, carbonate-group minerals) to form the mudstones enriched in bituminous substance of low maturity. The organic matter found in the rocks from both regions is of mixed terrestrial/marine origin and was deposited in the presence of low oxygen concentration and reducing and/or dysoxic conditions.

Validation by Molecular Dynamics of the Major Components of Sugarcane Vinasse, On a Surface of Calcium Carbonate (Calcite)

There is ongoing interest in the alcohol industry to significantly reduce and/or add value to the liquid residue, vinasse, produced after the distillation and rectification of ethanol from sugar cane. Vinasse contains potassium, glycerol, and a protein component that can cause environmental issues if improperly disposed of. Currently, some industries have optimized their processes to reduce waste, and a significant proportion of vinasse is being considered for use as an additive in other industrial processes. In the manufacture of cement and asphalt, vinasse has been used in the mixtures at low concentrations, albeit with some physical and mechanical problems. This work is the first molecular approximation of the components of the sugar cane vinasse in an industrial context, and it provides atomic details of complex molecular events. In the current study, the major components of sugar cane vinasse, alone or complexed on the surface of calcium carbonate, were modeled and simulated using molecular dynamics. The results showed that the protein component, represented by the mannoprotein Mp1p, has a high affinity for forming hydrogen bonds with potassium and glycerol in the vinasse. Additionally, it provides atomic stability to the calcium carbonate surface, preserving the calcite crystalline structure in the same way potassium ions interact with the carbonate group through ion–dipole interactions to improve the cohesion of the modeled surface. On the contrary, when the glycerol molecule interacts with calcium carbonate using more than two hydrogen bonds, it triggers the breakdown of the crystalline structure of calcite expanding the ionic pair.

Calcium Carbonate Attenuates Withdrawal and Reduces Craving: A Randomized Controlled Trial in Alcohol-Dependent Patients

<b><i>Introduction:</i></b> Preclinical studies have shown that calcium seems to be the active component of the anti-craving drug acamprosate (Ca²⁺ bis-acetyl-homotaurinate). Clinical effects in humans have also indicated an association between increased calcium plasma concentration due to acamprosate treatment and better outcome relating to time to relapse and cumulative abstinence. In contrast, low calcium concentration in alcohol-dependent patients was related with craving for alcohol. The main goal of the trial was to investigate whether an oral calcium administration is able to affect craving, withdrawal, and relapse risk in alcohol-dependent patients. <b><i>Methods:</i></b> We conducted a single-blind, randomized, monocentric, controlled clinical two-arm trial in alcohol-dependent patients (Clinical Trials Registration: DRKS00011293). A total of 55 alcohol-dependent subjects received calcium carbonate (800 mg + 5 μg vitamin D) versus sodium bicarbonate (1,000 mg) daily during the 14 days of inpatient alcohol-withdrawal treatment. <b><i>Results:</i></b> Based on an intention-to-treat protocol, withdrawal intensity (assessed with CIWA-Ar) in the calcium carbonate group attenuated faster than in the sodium bicarbonate subgroup. Alcohol craving (assessed with OCDS) in the calcium carbonate subgroup was also significantly reduced versus the sodium bicarbonate subgroup. <b><i>Conclusion:</i></b> Our data support earlier findings and show that treatment with calcium carbonate during alcohol withdrawal reduces symptoms of alcohol withdrawal as well as alcohol craving in a controlled clinical pilot study. Mode of actions will need to be determined to allow the further development of pharmacological interventions beyond Ca²⁺ bis-acetyl-homotaurinate.

Optimal Phosphate Control Related to Coronary Artery Calcification in Dialysis Patients

BackgroundIn patients on maintenance dialysis, cardiovascular mortality risk is remarkably high, which can be partly explained by severe coronary artery calcification (CAC). Hyperphosphatemia has been reported to be associated with the severity of CAC. However, the optimal phosphate range in patients on dialysis remains unknown. This study was planned to compare the effects on CAC progression of two types of noncalcium-based phosphate binders and of two different phosphate target ranges.MethodsWe conducted a randomized, open-label, multicenter, interventional trial with a two by two factorial design. A total of 160 adults on dialysis were enrolled and randomized to the sucroferric oxyhydroxide or lanthanum carbonate group, with the aim of reducing serum phosphate to two target levels (3.5–4.5 mg/dl in the strict group and 5.0–6.0 mg/dl in the standard group). The primary end point was percentage change in CAC scores during the 12-month treatment.ResultsThe full analysis set included 115 patients. We observed no significant difference in percentage change in CAC scores between the lanthanum carbonate group and the sucroferric oxyhydroxide group. On the other hand, percentage change in CAC scores in the strict group (median of 8.52; interquartile range, −1.0–23.9) was significantly lower than that in the standard group (median of 21.8; interquartile range, 10.0–36.1; P=0.006). This effect was pronounced in older (aged 65–74 years) versus younger (aged 20–64 years) participants (P value for interaction =0.003). We observed a similar finding for the absolute change in CAC scores.ConclusionsFurther study with a larger sample size is needed, but strict phosphate control shows promise for delaying progression of CAC in patients undergoing maintenance hemodialysis.Clinical Trial registry name and registration number:Evaluate the New Phosphate Iron-Based Binder Sucroferric Oxyhydroxide in Dialysis Patients with the Goal of Advancing the Practice of EBM (EPISODE), jRCTs051180048

Synthesis and Characterization of 50S8P Bioglass through Sol Gel Method

Bioactive glasses (BG) were applied in bone and dental applications as well as in tissue engineering. In this studies, a new bioglass 50S8P (50% SiO2, 22% CaO, 20% Na2O and 8% P2O5) with different aging time (3, 7, 10 and 15 days) was prepared by sol-gel method. These synthesized glasses were analyzed using X- ray powder diffraction (XRD), Scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). The bioactivity of all BG is evaluated by incubating the BG powder in Hank's Balanced Salt Solution (HBSS) for 7, 14 and 21 days. Thermal analyses indicated the compositions can be stabilized at 700°C. XRD confirmed the primary crystalline phase was Na4Ca4Si6O18. Formation of silica network is established with the existence of functional group Si-O-Si (tetrahedral), confirmed with FTIR analyses. In vitro test confirm the apatite formation on the BG surface with characteristic of carbonate group (C-O) and P-O band noticed from FTIR and morphology of apatite formation on BG surface was observe using SEM

Evaluation of the In Vivo Biocompatibility of Amorphous Calcium Phosphate-Containing Metals

Among the biomaterials based on calcium phosphate, hydroxyapatite has been widely used due to its biocompatibility and osteoconduction. The substitution of the phosphate group by the carbonate group associated with the absence of heat treatment and low synthesis temperature leads to the formation of carbonated hydroxyapatite (CHA). The association of CHA with other metals (strontium, zinc, magnesium, iron, and manganese) produces amorphous calcium phosphate-containing metals (ACPMetals), which can optimize their properties and mimic biological apatite. This study aimed to evaluate the biocompatibility and biodegradation of ACPMetals in mice subcutaneous tissue. The materials were physicochemically characterized with Fourier Transform InfraRed (FTIR), X-Ray Diffraction (XRD), and Atomic Absorption Spectrometry (AAS). Balb-C mice (n = 45) were randomly divided into three groups: carbonated hydroxyapatite, CHA (n = 15), ACPMetals (n = 15), and without implantation of material (SHAM, n = 15). The groups were subdivided into three experimental periods (1, 3, and 9 weeks). The samples were processed histologically for descriptive and semiquantitative evaluation of the biological effect of biomaterials according to ISO 10993-6:2016. The ACPMetals group was partially biodegradable; however, it presented a severe irritating reaction after 1 and 3 weeks and moderately irritating after nine weeks. Future studies with other concentrations and other metals should be carried out to mimic biological apatite.